The effects of lovastatin in hyperlipidemic patients with the nephrotic syndrome.
Hypercholesterolemia may pose a substantial risk for cardiovascular disease. The present investigation was designed to evaluate the safety and efficacy of the cholesterol synthesis inhibitor, lovastatin, in 13 nephrotic patients with 5.6 +/- 0.7 g/24 h of albuminuria. All patients were maintained on a low cholesterol diet throughout the study. After a 4-week placebo period, lovastatin was administered, 20 mg twice daily for 6 weeks. Lovastatin reduced total cholesterol by 27% from 8.6 +/- 0.6 mmol/L (331 +/- 24 mg/dL) to 6.3 +/- 0.4 mmol/L (242 +/- 17 mg/dL) (P less than 0.01), low-density lipoprotein cholesterol by 27%, from 5.8 +/- 0.5 mmol/L (223 +/- 20 mg/dL) to 4.2 +/- 0.6 mmol/L (163 +/- 22 mg/dL) (P less than 0.01), and apolipoprotein B by 29%, from 153 +/- 12 mg/dL to 109 +/- 8 mg/dL to 109 +/- 8 mg/dL P less than 0.01). Triglycerides and very-low-density lipoprotein (VLDL) cholesterol levels were also reduced by 30% and 37%, respectively (P less than 0.01). High-density lipoprotein (HDL) cholesterol, and apolipoproteins A-1 and A-2 were not significantly altered. Renal function and urine protein excretion were not affected by lovastatin. Although one patient developed diarrhea and discontinued treatment before completing 6 weeks of lovastatin, the other 12 patients had no adverse effects. In this short-term study, lovastatin therapy had few side effects and had favorable effects on the lipoprotein profile of nephrotic syndrome patients.
Kasiske
B L
BL
Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis 55415.
Velosa
J A
JA
Halstenson
C E
CE
La Belle
P
P
Langendörfer
A
A
Keane
W F
WF
D000328:Adult; D000368:Aged; D001053:Apolipoproteins / Q000097:blood; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000209:etiology; D008148:Lovastatin / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000097:blood / Q000150:complications*
D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D002784:Cholesterol; D008148:Lovastatin; D003404:Creatinine